title: Preoperative C-reactive protein as a prognostic and therapeutic marker for colorectal cancer.
abstract: OBJECTIVE
  This study aimed to evaluate the significance of preoperative C-reactive protein (CRP) as a prognostic marker for carcinoembryonic antigen (CEA)-independent stage I or II colorectal cancer (CRC) patients.
  
  
  METHODS
  Preoperative CRP was measured in 300 CRC patients to assess its relationships with clinicopathological factors and long-term survival. Based on the results of the initial study, the relationship between preoperative CRP and long-term survival was evaluated with reference to adjuvant 5-fluorouracil (5-FU)-based chemotherapy in a further 128 stage II patients.
  
  
  RESULTS
  CRP was associated with disease progression and factors reflecting nutritional depletion such as serum albumin, lymphocyte count and body weight loss ratio. In stage I or II patients, CRP could predict early disease recurrence, even when a CEA test could not. Multivariate analyses revealed that CRP was an independent prognostic variable in stage I or II patients. In the additional 128 stage II patients, CRP-positive patients showed a 3-year survival rate of only 55% without adjuvant chemotherapy, but this increased to 90% with adjuvant chemotherapy.
  
  
  CONCLUSIONS
  CRP may be a potent prognostic and therapeutic indicator that provides valuable information for determining the need for adjuvant chemotherapy in stage II CRC patients.
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie, Japan. koikyon@clin.medic.mie-u.ac.jp
authors.forename: Yuhki
authors.initials: Y
authors.lastname: Koike
authors.forename: Chikao
authors.initials: C
authors.lastname: Miki
authors.forename: Yoshinaga
authors.initials: Y
authors.lastname: Okugawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yokoe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Toiyama
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D015431:Weight Loss
chemical_list: D000964:Antimetabolites, Antineoplastic; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D012709:Serum Albumin; D002097:C-Reactive Protein; D005472:Fluorouracil